Starting off, I would like to thank Marion Kenyon and the staff of Apollo Day Spa for inviting me to participate in their Open House on February 13.  I performed a number of demonstrations using Botox and Juvederm tissue filler and answered many great questions from the observers present.  In fact, their questions inspired me to fill this week’s newsletter with some basic but pertinent information about fillers and their most recent advancements.

 

The first soft tissue fillers consisted of bovine collagen, a substance first approved by the FDA back in 1981.  As the name bovine would suggest, this product came from collagen collected from cows after they were slaughtered.  The bovine was then ground up, purified, sterilized, and ultimately injected into people’s skin for correcting scars and filling lines & wrinkles.  Even if the concept of being injected by cow material does not sound bad enough to you in a Frankenstein-like way, there were in fact many other disadvantages.  The results did not last long, and patients needed prior skin testing as allergic reactions at injection sites were common.

 

Fortunately, there have been tremendous advances in filler biotechnology since the days of injecting cow parts into human skin.  Although no perfect filler exists, hyaluronic acid fillers remain the most reliable on the market.  Most of the fillers produced by various companies are based on this chemical.  Hyaluronic acid (HA) is a naturally occurring chemical that is highly concentrated in connective tissue and collagen.  It is ideal to use because it is chemically the same as human tissue, thereby eliminating the need for skin testing and having virtually no adverse reactions.  I have been using these materials in my practice for five years, and none of my patients have ever had a negative skin reaction.

 

One of the most important features of HA is that it is hydrophilic, meaning that it attracts and binds water.  As a result of this characteristic, it can intertwine with the body’s own collagen, giving the skin area flexibility while also hydrating the area, thereby adding smoothness and substance to the skin.  With aging and damage to the skin (think sun and smoking), naturally formed HA decreases.  This reduction of HA causes dehydration of the skin and loss of flexibility, finally resulting in wrinkles.

 

If pure, natural HA is injected under the skin, like collagen, it can be rapidly broken down by the body and removed.  The companies that make the current generation of HA fillers form a more stable molecule by a chemical process called “cross-linking”.  This “cross-linking” makes the chemical resistant to breaking down while retaining its ability to attract water.  The most cross-linked versions of HA are essentially thicker or more concentrated, making them last longer. That is why Perlane and Juvederm UltraPlus, the thickest products currently approved by the FDA, are rated to last at least one full year.

 

I always truthfully tell my patients who are receiving fillers (and observers) that the lines and wrinkles will look better immediately after the procedure and will improve steadily over the next several weeks.  I have even seen cases where the improvement is noticeable over a period of several hours, demonstrating the fullness progressively over that time.

 

The whole area of dermal fillers is an exciting field where research is ongoing constantly and I have continued to follow new developments through the medical literature and regular conferences.  I will inform you all as new products come on the market, along with information on which products actually work and which you should not waste your money on.

 

If you have any questions concerning this post and any other skin issues, please leave a comment, or call our office directly at (207) 873-2158 oremail through our website.

LATISSE: A BREAKTHROUGH PRODUCT FOR EYELASHES

 

Allergan, the company that develops Botox and Juvederm, rolled out a new product named “Latisse” just last year.  Approved by the FDA, Latisse is the first prescription treatment for eyelash hypotrichosis.  That’s a complicated word, I know, but it’s otherwise known as “not enough” or “inadequate eyelashes”.

 

The chemical component of Latisse, bimatoprost ophthalmic solution, was originally developed to be put in the eye as an eyedrop to treat glaucoma, and it is still also used for that purpose.  Interestingly enough, patients who were using the drops for glaucoma noticed an unexpected side effect: their eyelashes would grow longer, darker and thicker than before the treatment.  As a result of this observation, further testing and research was done, ultimately resulting in the development of Latisse.

 

Latisse affects the growth, or anagen phase, of the eyelash hair cycle by increasing both the length of the phase and the number of hairs.  When Latisse is applied to the upper eyelid once every day, effects like hair growth come gradually.  In clinical trials, Latisse users saw significant improvement in 8 weeks.  At week 16, statistics show 25% increase in eyelash length, 106% increase in eyelash thickness and 18% increase in eyelash darkness.

 

Latisse is safe when used as directed, but there are some restrictions.  Latisse should not be used if the person is allergic to eye drops or has been diagnosed with eye pressure problems such as glaucoma.  The most common side effects are eye itching or redness reported in about 4% of users.Using Latisse is relatively easy.  First, any eye makeup and contact lenses must be removed, preferably before bedtime.  Second, one drop of Latisse is placed on an applicator which comes included with the prescription. This applicator is then drawn across the upper eyelid margin at the base of the eyelashes.

 

Since Latisse is an FDA-approved prescription medication, you will need to consult a doctor (like me) to discuss the risks versus benefits.  Most pharmacies will not actually be carrying such a specialized product.  No need to worry, though.  At Maine Laser Skin Care, we will be dispensing the medication, and Latisse will not be covered by insurance prescription plans.

 

At this point, we are taking names of patients who are interested in Latisse and will be scheduling consultations when it is officially available, which will be soon.  We will also be having more information concerning Latisse on our website shortly.  Give Becky Gilbert a call at (207) 873-2158 to get on the Latisse consult waiting list.  Meanwhile, if you have any other questions concerning this article and any other skin issues, please leave a comment here on this blog, call our office directly or email through our website.

YOUR SKIN IS WHAT YOU EAT AND DRINK

 

I’m aware that the title of this blog post is unorthodox to say the least.  Although it may not put the prettiest picture in your head, it still got your attention, didn’t it?  Well, now I’ll explain what I mean by this title.

 

Nutrition plays a key role in the health and wellness of your skin.  What you regularly eat and drink not only fuels the body, but it also should provide the vital components to keep your skin looking young, strong and vital.  However, according to the US Department of Agriculture, most Americans don’t consume the adequate amounts of vitamins, minerals and antioxidants they need.

 

Truth be told, poor nutrition not only increases the risk of developing many systemic diseases such as diabetes and heart disease to name a few.  It also contributes to signs of premature skin aging.  Cell metabolism uses oxygen and nutrients to produce energy to run the cell itself.  Metabolism also produces waste products within the cell called “free radicals”, which are unstable atoms.  These “free radicals” can cause a dangerous chain reaction that can lead to the destruction of the cell itself.  Other types of stress on the body and skin such as smoking, UV light, and environmental toxins can also cause similar free radicals, leading to eventual cell damage.

 

Vitamins were discovered in the late 19th and early 20th century.  These and other chemicals were found to be antioxidants, meaning that they prevented the cell damage of free radicals.  In the most basic chemical terms, antioxidants bind up the free radicals and help to prevent the molecular alteration of cell damage.

 

Dr. Kenneth Cooper, of the Cooper Clinic in Texas, wrote a best-selling book, “The Antioxidant Revolution”.  In it, he discussed the role of these important antioxidants and good general nutrition in reversing the damage of aging and disease.  He believes and proved that proper supplementation, a balanced diet, plenty of fluids, and moderate exercise are all needed for good health and beautiful skin.  Additionally, topical antioxidants can protect the skin externally by binding the free radicals on the skin surface and preventing some of the damage caused by exposure to the sun.  As always, blocking the sun from damaging the skin in the first place is the first line of defense.

 

As the title of this article states, you and your skin are the result of what you take in and how you protect it.  As much as I like to help people reverse the damage to their skin by laser technology and injectable treatments, I believe that early prevention is the key to healthier skin in the long run.

 

If you have any questions concerning this article and any other skin issues, please leave a comment on our blog or call our office directly at (207) 873-2158 oremail through our website.

Acne:  What To Do Regardless of Age

Last week, my blog post concentrated on acne causes and other facts.  I also discussed the nasty problem of adult acne that seems to be increasing in frequency in recent years.  This week, I will discuss more treatments and new developments of this difficult problem.

In past decades, acne treatment was very singular in focus, meaning that only one type of remedy was used at a time.  Such a medication concentrated on treating only one aspect of the many causes of acne.  Recently, the latest philosophy is to attack acne on all fronts, and understandably so.  Current topical therapies that work best use combinations of ingredients to keep the acne in check.  These combined elements help to stop bacterial growth and reduce inflammation, sebum (oily matter in the hair follicles) production, & skin cell proliferation.

The best products for acne contain a combination of ingredients including retinols (that clear pores of excess cells and oil which can form pimples), benzoyl peroxide (that kills bacteria and increases oxygen into pores), salicylic acid (that kills bacteria and exfoliates) and glycolic acid (that eliminates old skin cells and fights inflammation).  The acne products I recommend contain these ingrediants in various combinations.  Maine Laser Skin Care’s own Acne Kits contain instructions on how and when to use the products and in what amounts.

For some acne patients, it may be necessary to use oral antibiotics to attack bacteria from the inside out.  Doxycycline and tetracycline are among the most common prescriptions that work for acne.  These antibiotics directly combat bacteria that feed off the oil and dead skin cells, and therefore treat and prevent pimples.

For many acne sufferers, topical products and antibiotics are not, by themselves, enough.  In 2002, the FDA approved the use of lasers to treat acne.  Since 2003, I have been using the 532 nanometer Aura Iridex laser to treat acne with excellent results.  This laser treats the root cause by destoring bacteria, shrinking oil glands and reducing pore size without damaging surrounding tissue.  Using the initial four treatment protocol over a period of two weeks can reduce active acne by as much as 70%.  Old and new acne scarring can be eliminated or significantly reduced by using a combination of several lasers that can target both superficial and deeper scars.  While the deepest scars will never completely go away, they can become much less prominent and can blend more easily into the person’s skin tone and complexion.

I am also looking to add to my regimen of acne treatments in the next year.  The most likely to be added soon is Photodynamic Therapy (or PDT) which involves the use of a topical prescription called Levulan.  Levulan highlights oil glands allowing the laser light to penetrate and destroy overactive glands also destroying bacteria.  PDT helps to treat severe cystic acne, acne rosacea, and even some types of skin cancer.  Another new treatment is the use of LED light for less severe acne cases (Blue Light is one brand name I have been looking at) with or without the use of Levulan or PDT.

When new treatments are available, I will let you know by this blog as well as adding the information to the website.  If you have any specific questions about these or any other skin care issues, call our office at (207) 873-2158 or email through our website.

Acne:  It’s Not Just For Teenagers Anymore

Although acne typically affects many teens, both male and female, adult acne is on the rise especially for women.  Some of the latest surveys show that 55% of new patients being treated for skin problems are adult females.  More on that statistic in just a moment.

 

First, though, I am sure many of you want to know the when, where, hows, and whys of this problem.When adult acne occurs, it lasts longer and usually does not resolve spontaneously without treatment.  The adult breakouts tend to center on the chin, jawline and neck.  Disturbingly, such breakouts occur when an adult is in his or her 20’s, and could potentially last well into his or her mid-40’s.  Many of these adult acne sufferers also did not necessarily have breakouts as teens.

Many factors can lead to adult acne.  While one factor alone may be to blame in some circumstances, it is usually a combination of factors for most adults .  Stress is a major factor, as it stimulates the hormonal systems which in turn activate the sebaceous glands, providing a growth medium for skin bacteria.  Studies have in fact shown increased levels of acne in women with high stress and fast paced jobs.  Women also tend to have more papules (large red areas that don’t come to a head) which are painful and look very angry and inflamed.

Women tend to outnumber men in adult acne as opposed to other way around in the teenage years.  In adult females, acne breakouts also occur during times of hormone fluctuations such as ovulation, menstrual periods, pregnancy and menopause.  I have seen many cases where changes in oral contraceptive types or stopping “the pill” can trigger acne also.

Many experts also blame environmental triggers such as foods treated with hormones, air pollution, and products that come in contact with our skin that can increase inflammation (depending on one’s allergies).  Many supposedly “safe” skin treatments found over-the-counter in drugstores and supermarket can promote skin inflammation in sensitive patients.  Such products can contain skin dehydration elements such as alcohol.  Also, many people find that their skin gets more sensitive as they gets older due to damage over the years.

After this rather depressing news, you may be saying to yourself, “Dr. Burke, what do I do now?”.  In the next blog post, I will outline in more detail specific ingredients and treatments that can reverse and eliminate this pesky problem especially facing adult women. In the meantime, if you go to the acne products section of our website, I have a number of safe but effective products that I recommend for adult and teen acne.  These products are very compatible with sensitive skin and laser-treated patients.

Next time, I will also discuss other new, cutting-edge treatments that I am considering adding to our menu of care for the age-old and still frustrating problem of acne.  Meanwhile, feel free to call or e-mail us with any pressing skin care questions you may have.

Keeping Up Appearances in a Down Economy

Despite the current economic climate, more women and men than ever are undergoing appearance-enhancing procedures such as Botox, Juvederm/Restylane injections, and laser treatments to maintain their aesthetic regimen.  Many other patients are forgoing expensive facelifts and other plastic surgeries to opt for less costly and less permanent changes to their appearance.

According to a recent article in the Wall Street Journal, 75% of the aesthetic physicians surveyed reported an increased demand for minimally invasive (or non-surgical) procedures such as Botox, fillers, and laser treatments in 2008 alone.   Surgeries such as breast augmentation and nose reshapings dropped dramatically at the same time.  Additionally, many patients described their use of such non-surgical treatments as “maintenance”, “like comfort food” and “part of my cost of doing business” (the article’s words, not mine).So why is this story significant?  Why exactly are more people trying minimally invasive procedures over other surgeries?

 

It may be because patients such as yourselves are aware of the potential dangers of invasive surgeries.  More than that though, people are also becoming more aware of cost differentials, especially with all the unavoidable economic news making daily headlines.  Whereas the average cost of Botox is $300-$400, and fillers $900-$1000, other surgeries such as facelifts can cost as much as $15,000, and that bill is almost never covered by health insurance either.  Besides these obvious differences in cost and convenience, patient satisfaction really speaks for itself.Here at Maine Laser Skin Care, I have seen amazing growth in such procedures in the past year.  Botox use increased 65%, and Juverderm went up 300% in the past year due in no small part to the reasons listed above.  I’m also proud to report that our office ranks as 3rd in the state of Maine and in the top 20 for all of New England–not bad for a business based in rural Maine.  I owe this good news to you all who have continued to support us, and have given us great feedback and suggestions that we have made it a point to follow up with.

As always, with the winter upon us, don’t forget to moisturize and sun block (yes, even in winter) to protect your largest organ–YOUR SKIN.  Drink lots of fluids, and call us with any questions or to discuss any of our treatments.

Note:  This entry was originally written as an e-newsletter exclusively for our subscribers on January 11, 2009.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have.

Sunscreen Basics

Despite the abundance of information out there about sunscreens, there is still much confusion among the public and even the popular press about the importance of using it regularly.  Therefore, at the risk of sounding like a broken record, here are some basic, but vital, facts about sunscreen that are frequently forgotten, ignored or not well known:

1. Sunscreens do exactly what the name says: They screen the sun, but cannot completely block it.  Therefore, their strengths are limited, and the importance of reapplication every so often is commonly overlooked.
2. One should always use sunscreens that contain both UVA and UVB protection.
3. For best results year-round, use sunscreen as part of your every morning routine no matter what time of year and type of weather.  Autumn is no exception, and winter especially poses a higher risk of sunburn than many realize.
4. When planning to be outdoors for lengthy periods, it is best to apply sunscreen at least 30 minutes before leaving the house.
5. Even so-called waterproof sunscreens will come off in water or with perspiration over time.  With this in mind, see Fact #6 below.
6. When swimming or perspiring with exercise outdoors, it is recommended that you reapply sunscreen every hour.
7. Always apply sunscreen over the backs of the hands, the neck, tops of the ears, and (for bald or balding men) the top of the head.  These are common areas of skin cancer growth and photoaging, and should avoid sun exposure as much as possible.
8. If you use a moisturizer or makeup with sunscreen in it, make sure the SPF rating is at least 30, especially for facial use.
9. Regardless of the amount of sunscreen used, try to avoid sun exposure during the peak UV exposure times of 10 A.M. to 2 P.M.
10. The best sunscreen in the world (see our product line) won’t work if you don’t use it regularly, or properly for that matter.  Make it a daily habit, like brushing your teeth or combing your hair.

Also, I have said many times in this blog that it is far easier to prevent sun damage in the first place, than to repair its effects afterwards.  We have the technology to repair much of the damage, but simple prevention is far less expensive.  So go out there, have fun, and take special care of your largest organ–your skin. Thanks again for reading this, and for your consistent support!  We will keep providing you with our great customer service.

Botox Update II

I was presented with some very good news recently which you may be interested in.

I met with a representative from Allergan- the pharmaceutical company that makes Botox and Juvaderm.  She brought along some amazing information concerning the use of those products in my practice.  I’m proud to say that I currently rank in the Top 20 of all the aesthetic doctors in New England who use Botox and Juvaderm.  I also rank 3rd in the state of Maine. This is all the more amazing as many of the other skin doctors are in much more populated areas such as Portland, Maine, Burlington, Vermont and Portsmouth/Manchester/Concord, New Hampshire.

The number of people who use Botox has still been growing, but due to the hit the economy took, that growth has actually slowed down to 10% per year in the U.S. and to 4% per year in New England.  However, Maine Laser’s growth alone has stayed at over 50% per year every year since we started using Botox four years ago.

Our patient satisfaction scores and repeat patient treatments are both very high compared to other doctors in this field.  I am very proud of this growth and the response of patients to the availability of cutting-edge aesthetic care in central Maine.  Next month, in cooperation with Allergan, we will be rolling out several promotions to help keep Botox and Juvederm affordable.  We will keep you posted as plans develop.

Last but not least, I discussed Botox in more detail in an earlier post.  Because of these exciting developments I just detailed, I just posted that newsletter on our blog, so feel free to check that out if you have any further questions.

Thanks again for reading this, and for your consistent support!  We will keep providing you with our great customer service.

-This entry was originally written as an e-newsletter exclusively for our subscribers on September 21, 2008.  The information had been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have.

The Sun Is (STILL) Not Your Friend

It’s worth it to note that great summer weather isn’t fun for someone when sunburns are involved.  You’ll remember in a previous newsletter from last summer, “The Sun Is Not Your Friend”, I warned about the dangers of excess sun exposure in all seasons, including the wintertime.  Of course, exposure to the sun increases in the summer to a great degree because of changes in the Earth’s proximity to the sun in the Western hemisphere.  These changes result in increased ultraviolet rays released into the atmosphere. I write this warning not to scare you or to put a damper on your mood.  In fact, I guarantee that your summer, or whatever season it is, will be all the better if proper sunscreen is absorbed on the skin before going outside.  After all, ten minutes of applying the proper protection isn’t so much of an inconvenience compared to four days of intense burning, itching, and peeling of the skin.Furthermore, protection from the sun by sunblocks (SPF 30 or better) is also most important to protect from skin cancers and photoaging (i.e. premature wrinkles, blood vessels, age spots). If you’re still not convinced, consider this.  Last week, the National Institute of Health published a shocking study stating that over the past 20 years, cases of melanoma (the deadliest known form of skin cancer) in women have increased by nearly 50%.  This increase is thought to be due to increasing tanning booth usage, with the growth of the artificial tanning ndustry and outdoor exposure.  Men, for the record, were shown not to have any increase, which may be because of the limited number of males who engage in artificial tanning.I will wait until later to further delve into the other dangers of tanning booths.  But to reitterate, your best bet when stepping outside is to first apply sunblock with SPF 30 or better. Our brand of replenishing sunblock, for instance, provides guaranteed protection against burns and melanoma, and is good for your skin in other ways as well.-This entry was originally written as an e-newsletter exclusively for our subscribers on July 30, 2008.  The information has been edited to illiminate dated references, but the main points of the article, particularly the medical information, remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have. 

This entry was originally written as an e-newsletter exclusively for our subscribers on July 7, 2008.  The following information has been edited to illiminate dated references, but the main points of the article remain unchanged.  As always, feel free to contact us with any questions, or post any comments (within reason) you may have:

Rosacea- Part II: “Face Up” To Rosacea

I recently came to two realizations: 1.) I hadn’t written a monthly blog for the month of June, and 2.) I hadn’t written a follow-up to the post from October 2007, aptly named “Rosacea- Part I“.  Although I was probably taking a break from writing three newsletters in May [2008] alone, I still know that many of you were looking forward to the June newsletter, and I apologize again for the delay.  Having said that, this post serves as the ultimate catching up point for me as I bring you all more vital information on this serious but treatable skin condition.
 
It’s natural for people diagnosed with rosacea to feel isolated and embarassed by their skin.  However, everyone should know that rosacea is actually a very common skin condition.  An estimated 14 million Americans have rosacea in varying degrees.  In “Rosacea- Part I”, which can be found on our blog, I discussed many of the basics.
 
Women are affected by rosacea three times more frequently than men.  Common acute symptoms include flushing & red blotches appearing most commonly on the cheeks, nose, chin and forehead (in that order).
 
Broken blood vessels develop over time in addition to pimple-like bumps (acne rosacea).  In later and severe cases, rosacea can cause skin thickening with a characteristic swollen bumpy nose (most commonly seen in men).  Any rosacea patient knows that certain factors will trigger their flushing and make even mild rosacea look and feel worse.  Such common rosacea triggers include:

-Sun exposure
-Emotional stress
-Extremely hot or cold weather
-Humidity
-Excessive wind
-Excessive exercise
-Alcohol (especially red wine)
-Hot baths (including saunas)
-Spicy food
-Hot beverages
-Irritating skin treaments (especially any abrasive cleansers, dermabrasion & peels)

Obviously, avoiding these triggers can minimize flushing symptoms.  Unfortunately, once broken blood vessels develop, more active treatments are needed.  Topical treatments like Vitamin K can help stabilize these blood vessels.  Laser therapy currently remains the gold standard for both reducing broken vessels and preventing skin thickening.
 
If you have any specific questions about rosacea and its treaments, please call us at (207) 873-2158, e-mail us, or comment on our blog.  As always, product specials for each month are listed on our website. 

Thanks again for reading this, and for your continuing support!